From the Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Finland (M.L.-P., P.G., S.T., S.S., J. Lahti, K.H., J. Lipsanen, H.L., K.R.).
National Institute for Health and Welfare, Helsinki, Finland (M.L.-P., S.S., E.K.).
Hypertension. 2020 Jun;75(6):1429-1438. doi: 10.1161/HYPERTENSIONAHA.119.14140. Epub 2020 Apr 20.
The associations of maternal hypertensive pregnancy disorders with offspring mental disorders remain unclear. We examined whether maternal hypertensive disorders and maximum blood pressure during pregnancy predict offspring childhood mental disorders, whether the associations are independent of maternal and paternal mental disorders and paternal hypertensive disorders, independent of or additive with maternal early pregnancy overweight/obesity and diabetes mellitus disorders, and mediated or moderated by preterm birth, small-for-gestational-age birth and neonatal intensive care unit admission. Our prospective study comprised 4743 mother-child dyads of Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study. Women were recruited to the study in early pregnancy at Finnish maternity hospitals. Children were born 2006 to 2010 and followed-up until December 31, 2016, to ages 6.4 to 10.8 years. Hypertensive pregnancy disorders were identified from medical records, Medical Birth Register, and Care Register for Health Care. Systolic and diastolic blood pressure were measured at antenatal clinics and hospital visits. Mental disorder diagnoses were identified from Care Register for Health Care. Maternal gestational and chronic hypertension, preeclampsia and its severity increased offspring hazard of any childhood mental disorder. The associations of preeclampsia (hazard ratio=1.66 [95% CI, 1.14-2.42]) and severe preeclampsia (hazard ratio=2.01 [95% CI, 1.08-3.73]) were independent of all covariates. Maternal hypertensive and diabetes mellitus disorders and overweight/obesity also additively increased offspring hazard of mental disorders. Preterm and small-for-gestational-age births and neonatal intensive care unit admission partially mediated the effects of any and severe preeclampsia on offspring mental disorders. To conclude, maternal hypertensive pregnancy disorders carry adverse consequences for offspring mental health.
母亲高血压妊娠疾病与子女精神障碍的关联仍不清楚。我们研究了母亲高血压疾病和怀孕期间的最高血压是否能预测子女的儿童期精神障碍,这些关联是否独立于母亲和父亲的精神障碍和父亲的高血压疾病,是否独立于或与母亲早孕超重/肥胖和糖尿病有关,是否通过早产、小于胎龄儿出生和新生儿重症监护病房入院来调节或缓和。我们的前瞻性研究包括来自预测和预防子痫前期和宫内生长受限研究的 4743 对母婴对子。妇女在芬兰的妇产科医院早期妊娠时被招募到该研究中。孩子于 2006 年至 2010 年出生,并随访至 2016 年 12 月 31 日,年龄为 6.4 至 10.8 岁。高血压妊娠疾病是从医疗记录、医学出生登记册和医疗保健护理登记册中确定的。收缩压和舒张压在产前诊所和医院就诊时测量。精神障碍诊断是从医疗保健护理登记册中确定的。母亲的妊娠期和慢性高血压、子痫前期及其严重程度增加了子女任何儿童期精神障碍的发病风险。子痫前期(危险比=1.66[95%可信区间,1.14-2.42])和重度子痫前期(危险比=2.01[95%可信区间,1.08-3.73])的关联独立于所有协变量。母亲的高血压和糖尿病以及超重/肥胖也增加了子女精神障碍的发病风险。早产、小于胎龄儿和新生儿重症监护病房入院部分调节了任何子痫前期和重度子痫前期对子女精神障碍的影响。总之,母亲的高血压妊娠疾病对子女的心理健康有不良影响。